Ask the Neonatologist: Your Top 10 Preemie Questions, Answered

Bringing a premature baby into the world comes with countless questions, fears, and uncertainties. To help ease some of those concerns, we spoke with Dr. Emily Carter, a board-certified neonatologist with over 15 years of experience in neonatal intensive care.

Here, she answers the most common questions from preemie parents—from NICU stays to long-term development.

1. “Why Was My Baby Born Early, and Could I Have Prevented It?”

Dr. Carter: “There are many reasons for preterm birth, including infections, placental issues, multiples (twins/triplets), chronic health conditions (like preeclampsia or diabetes), or sometimes no clear cause at all. In most cases, it’s not the parent’s fault—prematurity is often unpredictable and unpreventable. The best thing you can do now is focus on supporting your baby’s growth.”

2. “How Do You Calculate My Preemie’s ‘Adjusted Age’?”

Dr. Carter: “Adjusted age (or corrected age) accounts for how early your baby was born. If your baby arrived 8 weeks early, at 6 months old, their adjusted age is 4 months. We use this until about 2–3 years old to track milestones fairly. Pediatricians will monitor both their actual and adjusted age.”

3. “What Are the Biggest Health Risks for Preemies?”

Dr. Carter: “The most common concerns are:

• Breathing issues (apnea, bronchopulmonary dysplasia)
• Feeding difficulties (weak suck/swallow, reflux)
• Infections (due to underdeveloped immune systems)
• Retinopathy of prematurity (ROP) (eye development)
• Developmental delays (motor skills, speech)

However, not all preemies face these, and many outgrow challenges with time and therapy.”

4. “When Can My Preemie Come Home from the NICU?”

Dr. Carter: “The biggest requirements are:
✔ Stable breathing (no apnea spells for several days)
✔ Consistent weight gain (without IV nutrition)
✔ Ability to regulate body temperature
✔ Successful feeding (breast, bottle, or NG tube mastery)

Most preemies go home around their original due date, but some stay longer depending on complications.”

5. “How Can I Boost My Preemie’s Immune System?”

Dr. Carter: “Preemies have weaker immunity, so:

• Strict handwashing (for family & visitors)
• Limit public outings (especially in RSV/flu season)
• Breast milk (packed with antibodies)
• Follow the adjusted vaccine schedule
• Avoid sick visitors until your pediatrician approves

Some preemies qualify for Synagis (RSV prevention shots)—ask your doctor.”

6. “Will My Preemie Have Long-Term Health Problems?”

Dr. Carter: “Many preemies grow up without major issues, especially those born after 28 weeks. However, extremely early babies (under 26 weeks) may face higher risks for:

• Learning differences (ADHD, processing delays)
• Asthma or lung conditions
• Cerebral palsy (rare, but monitored)

Early intervention (PT, OT, speech therapy) makes a huge difference—so don’t skip follow-ups!”

7. “Is Kangaroo Care Really That Important?”

Dr. Carter: “Absolutely! Skin-to-skin contact:

• Stabilizes heart rate & breathing
• Improves weight gain
• Reduces stress (for baby AND parent)
• Enhances bonding when you can’t hold them much

Even 30 minutes a day helps—ask your NICU staff for guidance.”

8. “How Do I Handle the Emotional Toll of the NICU?”

Dr. Carter: “Parental stress in the NICU is normal but overwhelming. My advice:

• Talk to a therapist (many NICUs have social workers)
• Connect with other preemie parents (they get it)
• Celebrate tiny victories (1ml more milk, fewer alarms)
• Let yourself grieve the ‘typical birth’ you imagined

You’re not failing—you’re surviving.”

9. “What’s the Best Way to Advocate for My Baby in the NICU?”

Dr. Carter: “Be the expert on your child by:
📝 Keeping a NICU journal (weights, care times, questions)
💬 Asking ‘Why?’ (if a test/treatment seems unnecessary)
👥 Requesting care team meetings to discuss progress
🛑 Speaking up if something feels ‘off’ (parent intuition is real!)

NICU staff want you involved—don’t hesitate to ask.”

10. “What Gives You Hope as a Neonatologist?”

Dr. Carter: “I’ve seen micro-preemies (under 2lbs!) grow into thriving kids. Medicine advances every year, and preemie outcomes keep improving. Your baby is stronger than you know—and so are you.”

Final Thought for Parents

“Prematurity is a marathon, not a sprint. Compare your baby only to themselves, not full-term infants. With love, time, and support, most preemies catch up beautifully.”

Do you have a NICU or preemie question we didn’t cover? Drop it here, and we’ll ask Dr. Carter in a follow-up! 💛